Patellar Dislocation and Reduction

imagesClinical suspicion of patellar dislocation


   imagesThe knee is held in 20 to 30 degrees of flexion


   imagesAn obvious deformity is typically seen


   imagesDislocated patella on x-ray (anteroposterior [AP] or sunrise views; lateral view less helpful)


CONTRAINDICATIONS



imagesFracture


imagesEffusion (hemarthrosis)


TECHNIQUE



imagesPatellar dislocations frequently relocate spontaneously before the patient seeks treatment


imagesIntravenous Sedation and Muscle Relaxation


   imagesOften the procedure may be accomplished without use of sedation or muscle relaxation


imagesReduction Procedure


   imagesReduction is performed by manually applying pressure to the patella in an anteromedial direction while extending the extremity


      imagesA palpable relocation should be felt and confirmed by relief of the patient’s symptoms


   imagesReduction may be difficult due to the medial patellar facet being locked on to the lateral femoral condyle


      imagesIn these cases, apply downward pressure to the lateral patella which creates the external rotational force needed to unlock the facet (FIGURE 64.1). Continue with the standard reduction technique.



images


FIGURE 64.1 Apprehension test.

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Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Patellar Dislocation and Reduction

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